Remote Authorization Representative
APR Consulting, Inc. has been engaged to identify a Remote Authorization Representative
Location: Sacramento, CA 95833
Position: Remote Authorization Representative
Pay Rate: $25/hr
Duration: 26 weeks
Expected Shift: Remote | AM shift, 5×8-hour days
Summary / Duties:
The Authorization Coordinator I supports the Central Authorization Optimization Program by processing referral and prior authorization requests, monitoring pending referrals, and documenting status updates accurately in Epic and related managed care systems. This role covers incoming phones, email escalations, and RightFax authorization requests to help reduce backlog, improve turnaround times, and support provider and patient access to care. The coordinator follows UM protocols, payer contract requirements, and standard work to complete requests within scope or route cases to nurses or physicians when needed. Candidates should be prepared to discuss specific examples of referral, authorization, documentation, payer follow-up, and issue-resolution experience in a remote setting.
Requirements:
- HS diploma or equivalent education/experience
- Epic experience required
- Experience with referral processing, prior authorizations, or utilization management workflows
- Experience with CPT, HCPCS, ICD-9/ICD-10, medical terminology, and payer requirements
- Ability to process incoming phones, email escalations, and RightFax authorization requests
- Ability to monitor pending referrals and meet turnaround time standards
- Proficiency in Microsoft Word, Excel, EMR documentation, and managed care systems
- Ability to provide clear, detailed, and direct responses to situational workflow questions
Preferred Requirements:
- Experience with high-volume central authorization or revenue cycle environments
- Experience verifying insurance eligibility and coordinating with providers, patients, and payers
- Experience resolving referral, claims, denial, or authorization-related issues
- Ability to work independently in a stable remote environment
- Ability to ask thoughtful questions and communicate workflow gaps or anticipated issues
Our client is the one of the largest Healthcare Staffing Provider in the United States, to be assigned at one of their affiliated hospitals/healthcare facilities.
Since 1980 APR Consulting, Inc. has provided professional recruiting and contingent workforce solutions to a diverse mix of clients, industries, and skill sets nationwide.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
Don't miss out on this amazing opportunity! If you feel your experience is a match for this position please apply today and join our team. We look forward to working with you!
APR Consulting, Inc., is one of the most trusted talent acquisition and workforce solutions providers in the United States. Known for exceptional responsiveness, agile strategies, and consistently high-level talent, the firm has become a go-to for organizations and managed services providers navigating complex change and urgent challenges. Since its founding in 1980, APR has transformed from a California IT-focused staffing firm to a full-service solutions provider filling a wide range of positions and serving over eight industries — including aerospace and defense, healthcare, IT, telecom, hospitality/gaming, sports/entertainment, government, and utilities –– in all 50 states, with a loyal roster of more than 850 specialized professionals.